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General NPI Number Information
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NPI Number | 1659888501
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Entity Type | Organization
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Legal Business Name | KROTHAPALLI DENTAL GROUP GAHANNA LLC
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Dates
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Enumeration Date | 01/01/2018
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Last Update Date | 01/01/2018
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Provider Practice Location Address
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Address Line | 156 GRANVILLE ST
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City | GAHANNA
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State | OH
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Zip | 43230-6505
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Country | US
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Telephone | 614-475-2616
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Fax |
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Provider Business Mailing Address
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Address Line | 135 HOFF RD STE B
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City | WESTERVILLE
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State | OH
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Zip | 43082-7184
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. NANARAO KROTHAPALLI
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Credential |
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Telephone | 617-223-1652
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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